Objective To investigate the therapeutic effects of different surgical procedures for the treatment of gallbladder cancer. Methods The clinical data of 81 patients with gallbladder cancer who were admitted to the West China Hospital of Sichuan University from January 2000 to October 2009 were retrospectively analyzed.The efficacies of different surgical procedures for the treatment of gallbladder cancer, and the relationship between T stage and lymph node metastasis were investigated. The postoperative survival rates of patients in different TNM stages were analyzed and compared using the Kaplan-Meier method and Log-rank test, respectively. Results The median survival times of patients in stage Ⅰ , Ⅱ ,Ⅲ and Ⅳ were 68, 18, 7 and 5 months, respectively. The 1-,3-, 5-year survival rates were 100%, 80% and 60% for patients in stage Ⅰ, 57%, 29% and 14% for patients in stage Ⅱ, 27%, 7% and 0 for patients in stage Ⅲ and 11%, 4% and 0 for patients in stage Ⅳ. There were significant differences in the survivals of patients in different TNM stages ( P ＜ 0.05 ). Of the 81 patients, 67 received surgical treatment. The 5-year survival rate was 100% for patients in stage T1b who received standard radical resection and 0 for patients who received simple cholecystectomy. The median survival time was 45 months for patients in stage Ⅱ who received standard radical resection and 12 months for patients in stage Ⅱ who received simple cholecystectomy, and their 1-, 3-, 5-year survival rates were 67%, 33%, 33% and 50%, 0, 0, respectively, with significant differences ( P ＜ 0. 05 ). The 1-, 3-, 5-year survival rates of patients in stage Ⅲ who received standard radical resection were 33%, 17% and 6%, respectively. The survival time of patients who received extended radical resection was longer than 12 months, while the survival time of patients who received standard radical resection or other palliative therapy was shorter than 12 months. The 1-, 3-, 5-year survival rates of patients in stage Ⅳ who received extended radical resection and standard radical resection were 38%, 12%, 0and 14%, 0, 0, respectively. The survival time of patients in stage Ⅳ who received other treatments was shorter than 12 months. Lymph node metastasis were identified in 7 patients in stage T2(n = 15), 7 patients in stage T3(n = 14), and 12 patients in stage T4(n = 13), no patient in stage T1 (n =2) was found with lymph node metastasis. Conclusions Lymph node metastasis is significantly influenced by the depth of invasion of the gallbladder cancer. For patients in stage T1b, Ⅱ and Ⅲ, radical resection of gallbladder cancer is necessary; for patients in stage Ⅳ, although the incidence of complication is higher, the survival time is much longer when compared with other treatments.

Objective: To investigate the effect of arterial baroreflex (ABR) on survival rate of rats with cecal ligation and puncture (CLP)-induced sepsis. Methods: Male Sprague -Dawley rats were divided into 2 groups: sham-operated rats (n=22) and sinoaortic denervated (SAD) rats (n=22). Four weeks after SAD rats were subjected to CLP-induced sepsis, the blood pressure and heart period (HP) were monitored for 12 hours in conscious state and the survival of rats was observed. Results: Both the diastolic and systolic blood pressue gradually decreased after CLP; the HP shortened first and then drastically prolonged until the death of rats. At 12 h after CLP the survival rate of SAD rats was lower than that of the sham-operated rats (59% vs 86%). Significant differences were found between the Kaplan-Meier survival curves of the rats in 2 groups (P<0.05). Conclusion: ABR plays an important role in CLP-induced lethal sepsis model.

OBJECTIVETo study the applied value of double joystick technique in reduction-internal fixation for femoral shaft fracture in adults.

METHODSThirty-four patients (24 males and 10 females) with femoral shaft fractures were treated with reduction assisted by double joystick technique and internal fixation with interlocking intramedullary nail from September 2010 to June 2013. The average age of the patients was 41 years old, ranged from 17 to 65 years old. The duration of the disease course ranged from 3 to 7 days, with a mean of 5 days. The fractures belonged to AO types 32A (5 cases), 32B (20 cases) and 32C (9 cases) and located in left femur for 18 patients and right femur for 16 patients. The patients were followed up, and fracture healing and complications were observed. The curative effect were evaluated according to Thorsen femur fracture evaluation standard.

RESULTSThe operative time ranged from 40 to 110 min (mean 75 min) and intraoperative blood loss ranged from 200 to 300 ml (mean 250 ml). All the patients obtained a good fracture reduction and were followed up for 12 to 24 months (mean 18 months) after the surgery. All the fractures united between 4 and 8 months with a mean of 5 months. No complications such as breakage of nail, infection, osteofascial compartment syndrome, refracture and fracture malunion were found. According to Thorsen femur fracture evaluation standard, 30 patients obtained an excellent result, 3 good and 1 fair.

CONCLUSIONIn surgery of reduction-internal fixation for femoral shaft fracture in adults, the use of double joystick technique obtains good reduction result, short operative time, less injury, high healing rate of bone fractures, less complications and good limbs function, so it is worthy of popularizing in clinic.

Adolescent ; Adult ; Aged ; Bone Nails ; Female ; Femoral Fractures ; physiopathology ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Young Adult

〔Abstract〕 In the paper , the status quo of mobile medical service is analyzed , proving a new mode of mobile medical service for pa-tients.The suggested functions like self -service information query and medical service guiding as well as solutions to the relevant system structure and information security are elaborated in detail .In addition, the feasibility of construction of applications for mobile medical di-agnosis and treatment is also discussed .

Hydrocarbons, Brominated ; metabolism ; toxicity ; Occupational Exposure

Objective To investigate the changes of histamine receptors in bladder before and after the treatment by sodium hyaluronate in rats of interstial cystitis (IC). Methods Twenty IC model rats were randomly divided into experimental group and control group, with 10 for each group.The bladders in experimental group were filled with sodium hyaluronate, while the rats in control group were executed at once. The bladders were dyed with HE staining, special staining and immunohistochemistry staining to count the number of mononuclear cells and mast cells and observe the changes of histamine receptors. Results In experimental group,the counts of mononuclear cells and mast cells were 12.20±2.48 and 2.90±0.87 respectively;the numbers of average optical of histamine receptor H1, H2, H3, H4 were 0.015±0.007, 0.006±0.001, 0.007±0.004, 0.061±0.026 , respectively. In control group, the counts of mononuclear cells and mast cells were 23.90±3.07 and 7.08±1.23;the numbers of average optical of histamine receptor H1, H2, H3, H4 were 0.055±0.033, 0.031±0.023, 0.033±0.017, 0.091±0.059, respectively. The differences of mononuclear cells and mast cells were significant between the 2 groups(P＜0.01). The differences of average optical of histamine receptor H1, H2, H3 between the 2 group were significant (P＜0.05), while the difference of histamine receptor H4 was not significant(P＞0.05). Conclusion Histamine receptor H1, H2, H3 take part in the development of IC, the antagons may be used for the treament of IC.

Objective To study the way of blocking the father-child、mother-child transmission of HBV.Methods 387 fathers or mothers who were positive for HBV-DNA were divided into three groups according to the father and mother's HBV-DNA and anti-HBsAg. Then they were randomly divided into three groups,one group were treated by HBIG,the second group were treated by lamivudine,the third group were treated by HBIG and Lamivudine.90 of their children who were positive for HBV-DNA were randimly dinded into three groups,one group were treated by hepatitis B Vaccine,the second group were treated by hepatitis B Vaccine and HBIG,the third group were treated by hepatitis B Vaccine and Gm-CSF. Their serum HBV-DNA were tested by fluorescence quantitative - PCR method.Results After treatment on the fathers or mothers,the degree of HBV-DNA was decreased obviously. There were significant difference between the groups who were treated by HBIG and lamivudine and the group who were treated only by HBIG or lamivudine( P ＜0.05 ). The rate of their newborn with HBV-DNA( + ) were significantly lower then other groups. After treatment on the newborn with HBV-DNA( + ). The degree of HBV-DNA had significant difference between the groups who were treated by both drug and vaccine and the vaccine group(P ＜0.05). Conclusion The fathers or mothers with HBV-DNA( + ) were treated by HBIG、lamivudine before they want a child, and fheir newborn with HBV-DNA( + ) were treated by vaccine、HBIG、Gm-CSF. This was an important way to block the father-child、mother-child transmission of Hepatitis B Virus.

By using the OEC 9600 mobile digital imaging system, 14 coronary stents were successfully implanted in all 13 cases of coronary heart disease. After the procedure,immediate satisfactory angiographic results were obtained without residual stenosis, and chest pain was relieved or disappeared in all cases. No major complications occurred except for groin hematoma in one case,these results suggest that intracoro-nary stenting is a safe and effective management for coronary heart disease.

When Po. Wang Xingkuan treating long cough, he is good at treating from the liver, clearly identifying mechanism, getting good effect in treating long cough of the type of Attack of the Lung by Liver Fire with revised Sit-blood Decoction.

Due to the complexity and risk of liver anatomy and operation, laparoscopic hepatectomy is still a challengeable procedure. In order to acquire the optimal treatment effect, we need to comprehensively analyze the general condition, hepatic reserve function of patients, and the pathway selection before this surgery. Compared with open hepatectomy, the advantage of laparoscopic hepatectomy for hepatocellular carcinoma has been widely recognized. Anatomical hepatectomy, regional resection technology, and precise hepatectomy promote the all-round development of minimal invasive liver surgery. With the navigation of indocyanine green and laparoscopic ultrasound, and the support of associating liver partition and portal vein ligation for staged hepatectomy, controlled low central venous pressure and other technologic revolution, laparoscopic hepatectomy is believed to bring new breakthrough in treatment of HCC. Although the number of HCC patients who underwent laparoscopic resection of is increasing, there are still numbers of problems, referred to technology applied and promoted, at home and abroad. This article aims to discuss the pathway selection, surgical indications and contraindications, transformation of concepts, technology annotation, and the control of complications in HCC treatment.